Cannon A wave validation as a diagnostic tool in paroxysmal supraventricular tachycardias
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Wiley
2024
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| author | David González‐Casal Alberto Pérez‐Castellanos Nina Soto Flores Alejandro Carta‐Bergaz Esteban González‐Torrecilla Vanesa Bruña Fernández Pablo Ávila Felipe Atienza Ángel Arenal Jorge González‐Panizo Francisco Fernández‐Avilés José Angel Cabrera Tomás Datino |
| author_facet | David González‐Casal Alberto Pérez‐Castellanos Nina Soto Flores Alejandro Carta‐Bergaz Esteban González‐Torrecilla Vanesa Bruña Fernández Pablo Ávila Felipe Atienza Ángel Arenal Jorge González‐Panizo Francisco Fernández‐Avilés José Angel Cabrera Tomás Datino David González‐Casal Alberto Pérez‐Castellanos Nina Soto Flores Alejandro Carta‐Bergaz Esteban González‐Torrecilla Vanesa Bruña Fernández Pablo Ávila Felipe Atienza Ángel Arenal Jorge González‐Panizo Francisco Fernández‐Avilés José Angel Cabrera Tomás Datino |
| collection | Wiley Open Access |
| contents | Cannon A wave validation as a diagnostic tool in paroxysmal supraventricular tachycardias David González‐Casal Alberto Pérez‐Castellanos Nina Soto Flores Alejandro Carta‐Bergaz Esteban González‐Torrecilla Vanesa Bruña Fernández Pablo Ávila Felipe Atienza Ángel Arenal Jorge González‐Panizo Francisco Fernández‐Avilés José Angel Cabrera Tomás Datino Pacing and Clinical Electrophysiology AbstractObjectiveThe presence of cannon A waves, the so called “frog sign”, has traditionally been considered diagnostic of atrioventricular nodal re‐entrant tachycardia (AVNRT). Nevertheless, it has never been systematically evaluated. The aim of this study is to assess the independent diagnostic utility of cannon A waves in the differential diagnosis of supraventricular tachycardias (SVTs).MethodsWe prospectively included 100 patients who underwent an electrophysiology (EP) study for SVT. The right jugular venous pulse was recorded during the study. In 61 patients, invasive central venous pressure (CVP) was registered as well. CVP increase is thought to be related with the timing between atria and ventricle depolarization; two groups were prespecified, the short VA interval tachycardias (including typical AVNRT and atrioventricular reciprocating tachycardia (AVRT) mediated by a septal accessory pathway) and the long VA interval tachycardias (including atypical AVNRT and AVRT mediated by a left free wall accessory pathway).ResultsThe relationship between cannon A waves and AVNRT did not reach the statistical significance (OR: 3.01; p = .058); On the other hand, it was clearly associated with the final diagnosis of a short VA interval tachycardia (OR: 10.21; p < .001). CVP increase showed an inversely proportional relationship with the VA interval during tachycardia (b = −.020; p < .001). CVP increase was larger in cases of AVNRT (4.0 mmHg vs. 1.2 mmHg; p < .001) and short VA interval tachycardias (3.9 mmHg vs. 1.2 mmHg; p < .001).ConclusionThe presence of cannon A waves is associated with the final diagnosis of short VA interval tachycardias. 10.1111/pace.14946 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/pace.14946 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_pace_14946 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2024 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Cannon A wave validation as a diagnostic tool in paroxysmal supraventricular tachycardias David González‐Casal Alberto Pérez‐Castellanos Nina Soto Flores Alejandro Carta‐Bergaz Esteban González‐Torrecilla Vanesa Bruña Fernández Pablo Ávila Felipe Atienza Ángel Arenal Jorge González‐Panizo Francisco Fernández‐Avilés José Angel Cabrera Tomás Datino Pacing and Clinical Electrophysiology Cannon A wave validation as a diagnostic tool in paroxysmal supraventricular tachycardias David González‐Casal Alberto Pérez‐Castellanos Nina Soto Flores Alejandro Carta‐Bergaz Esteban González‐Torrecilla Vanesa Bruña Fernández Pablo Ávila Felipe Atienza Ángel Arenal Jorge González‐Panizo Francisco Fernández‐Avilés José Angel Cabrera Tomás Datino Pacing and Clinical Electrophysiology AbstractObjectiveThe presence of cannon A waves, the so called “frog sign”, has traditionally been considered diagnostic of atrioventricular nodal re‐entrant tachycardia (AVNRT). Nevertheless, it has never been systematically evaluated. The aim of this study is to assess the independent diagnostic utility of cannon A waves in the differential diagnosis of supraventricular tachycardias (SVTs).MethodsWe prospectively included 100 patients who underwent an electrophysiology (EP) study for SVT. The right jugular venous pulse was recorded during the study. In 61 patients, invasive central venous pressure (CVP) was registered as well. CVP increase is thought to be related with the timing between atria and ventricle depolarization; two groups were prespecified, the short VA interval tachycardias (including typical AVNRT and atrioventricular reciprocating tachycardia (AVRT) mediated by a septal accessory pathway) and the long VA interval tachycardias (including atypical AVNRT and AVRT mediated by a left free wall accessory pathway).ResultsThe relationship between cannon A waves and AVNRT did not reach the statistical significance (OR: 3.01; p = .058); On the other hand, it was clearly associated with the final diagnosis of a short VA interval tachycardia (OR: 10.21; p < .001). CVP increase showed an inversely proportional relationship with the VA interval during tachycardia (b = −.020; p < .001). CVP increase was larger in cases of AVNRT (4.0 mmHg vs. 1.2 mmHg; p < .001) and short VA interval tachycardias (3.9 mmHg vs. 1.2 mmHg; p < .001).ConclusionThe presence of cannon A waves is associated with the final diagnosis of short VA interval tachycardias. 10.1111/pace.14946 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Cannon A wave validation as a diagnostic tool in paroxysmal supraventricular tachycardias |
| topic | Pacing and Clinical Electrophysiology |
| url | https://onlinelibrary.wiley.com/doi/10.1111/pace.14946 |